Individual
DR. MATTHEW ALAN GULLICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
710 PARK CENTER DR, STE 300, MATTHEWS, NC 28105-5012
(704) 323-2000
Mailing address
4601 PARK RD, STE 300, CHARLOTTE, NC 28209-3239
(704) 323-2000
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
2006-01940
NC
207X00000X
Orthopaedic Surgery Physician
27820
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
278202
—
SC
05
—
5905641
—
NC
Enumeration date
01/30/2006
Last updated
11/09/2023
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